|Elliana and Colby Zatyrka|
Flash forward to today in West Suffield, Connecticut. Mark and his wife Sasha just became the proud parents of twins Colby and Ellie, born on March 12. But the road to parenthood was not without its challenges. We sat down with Mark to discuss his and Sasha’s recent experiences and adventures in procreation.
You are HIV positive, and your wife is HIV negative. More important, you are both wonderful people. Can you tell me a little bit about the process you and Sasha went through in order to have children?
We were fortunate to find out that there was a sperm-washing laboratory within a couple hours of our house. [Sperm washing is a process in which the sperm are separated from the seminal fluid, which might contain HIV-infected material; the sperm is then later inseminated into the womb.] There are only a few in the whole country, so the fact we had one so close seemed to be a blessing. The facility was much more like a laboratory than a clinic or hospital. The woman in charge was nice and had experience not only with sperm washing, but also with other folks with hemophilia, which we really liked. However, it was all very much research centered.
They would mail us the semen analysis kit. In the kits were instructions that needed to be followed precisely, and then we would ship the kit back for them to test our specimen. It was nice we didn’t have to travel back and forth as much.
What was the hardest part of this process?
Unfortunately, we had some issues. Anytime we had a question or were waiting on results, it would take weeks, sometimes months for them to get back to us. Our biggest hurdle came when we were told they couldn’t continue the sperm-washing process because the viral load in my semen was not undetectable, even though the viral load in my blood had been undetectable for years. So we hit a wall. The doctor tried to figure out why this was happening and what could be done to fix it. At one point we waited over six months for them to get back to us about the results of a test we did. And when they did get back to us, the test was incomplete and they didn’t test for the information my ID [infectious disease] doctor needed.
After about three years, we needed to make a decision: keep moving at a rate slower than a snail’s pace with our current laboratory, look into adoption, or try a different sperm-washing facility.
I’ve heard about other couples in a similar situation who have "gone the natural route" with procreation, especially when the positive partner’s viral load is undetectable. Did you ever consider this?
When Sasha and I decided to make the plunge and have kids, we weighed our options. We were really considering three options: adopt, sperm washing, or natural. I felt uncomfortable taking the natural approach. I totally understand that it’s a good option for some folks, but I just was very uncomfortable putting Sasha at any risk if that risk could be eliminated or reduced by trying a different method. And while we are both very open to adoption, we preferred to try to have a child with our own genes and traits and personalities. So we decided to try sperm washing.
So what was the next step?
A second opinion. After speaking to someone we had a great deal of respect for, who we knew had a successful go at sperm washing in the hemophilia community, we decided to take his recommendation to try Mark V. Sauer, MD, at Columbia University Medical Center in New York City.
Our initial appointment was more of a consult. Sauer talked with us for about two hours. He was the first person to do sperm washing here in the states, and he has performed over 800 successful sperm washings since 1998. We felt extremely comfortable under his program. Another thing we loved was the fact he worked out of a reputable clinic under a major hospital. So it wasn’t just research offices, it was an actual hospital. With our first facility, they would have had to ship my washed sperm to another clinic to do the insemination process. At Columbia, it was all there at the same place.
But our major problem—[the detectable viral load in the semen samples]—was still on the table. Sauer told us that every facility has different protocols and standards. So while the first facility could not move forward because my viral load in my semen was at detectable levels, at Columbia, he doesn’t even test the viral load in the semen. He said there was no point because he doesn’t use the semen, he only uses the sperm. HIV lives in semen and not sperm. Not only does he not test for HIV in the semen, but he believes that the majority of the time someone’s viral load is detected in their semen, it’s a false positive result.
So the issue that held us up for over three years isn’t even looked at in Colombia! We were so excited.
After our initial consultation, we came back about a month later to start the process. Everything was great on my end. The sperm looked great. We started IVF [in vitro fertilization] right away, and within two months Sasha was pregnant! We could not believe how fast and smooth everything went.
Not only that—you and Sasha had twins! Plus you have a new member of the family in your spirited dog, Rocky. Did you always envision this, and if not, what made you feel like you were ready to tackle the adventure that is fatherhood?
Even as a young boy I always knew I wanted to have kids some day. I would save my favorite toys in hopes to one day pass that toy on to my own kids. I contracted HIV about 30 years ago when I was around 2 years old, from infusions to treat my severe hemophilia. However, I wasn’t told until I was around 12. Some of my immediate reactions to the news dealt with concerns about dating, stigma, school, medicine and my life expectancy. After about a year I started hearing little things here and there that led to me, all of a sudden, coming to the realization that I will never be able to have kids. This realization was just as devastating as my shortened life expectancy or any other concerns.
Sasha and I have always wanted kids, both before we met and in agreement after we started our relationship. Sasha actually wanted 10 kids when we first met. I would never even consider that—way too many for me. And over the years, Sasha’s number has come down and my number has actually gone up a little, as we both like and appreciate the dynamics a larger family creates. So we may shoot for three or four kids.
We really don’t have any regrets about the three years we spent at the first facility going nowhere. We did a lot during that time that we would not have been able to do if we had newborns. I’m one that believes everything happens for a reason. It was really the only rationale that got me through the whole HIV/hemophilia tragedy. The pregnancy went great. We couldn’t be happier.